One hour after birth, a postpartum client has heavy lochia a… | MyMerci
Lifestyle Choices HPM
Question

One hour after birth, a postpartum client has heavy lochia and a boggy uterus above the umbilicus. What is the nurse's priority action?

Explanation
A boggy uterus with heavy lochia suggests uterine atony, a common cause of postpartum hemorrhage. The priority is to massage the fundus to stimulate uterine contraction while continuing assessment and notifying the provider as needed. Delaying care can worsen bleeding.

In-depth explanation

Clinical Judgment
Postpartum bleeding plus a boggy fundus is a contraction problem until proven otherwise.

Memory Tip
Boggy fundus: massage first.

KR vs US
NCLEX postpartum questions often expect immediate bedside action before waiting for orders.

Clinical scenario

Clinical Practice Guide
Postpartum hemorrhage care includes rapid recognition of uterine atony, fundal massage, medication per order, bladder assessment, vital signs, and escalation.

Caution
Heavy lochia with a firm fundus suggests a different bleeding source and requires further evaluation.

Key concepts

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.